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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208902
Report Date: 04/12/2022
Date Signed: 04/12/2022 04:51:32 PM

Document Has Been Signed on 04/12/2022 04:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:TRU FOUNDATIONFACILITY NUMBER:
157208902
ADMINISTRATOR:APPLE, TIFFANYFACILITY TYPE:
735
ADDRESS:11509 TAGUS DRTELEPHONE:
(661) 472-3577
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 6CENSUS: 2DATE:
04/12/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Tiffany Apple, AdministratorTIME COMPLETED:
05:05 PM
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Licensing Program Analyst (LPA) L. Cabrera arrived at the facility unannounced to conduct a Health & Safety Inspection. LPA explained the purpose of the visit with Administrator Tiffany Apple. Covid Health Screening was conducted upon entering the facility.

During the visit, LPA toured the facility inside and out. LPA observed 2-day supply of perishable and 7 day nonperishable food supply. LPA observed resident medication in a locked cabinet, hand sanitizer throughout the facility and available PPE. During the visit, LPA interviewed residents and Administrator.

LPA obtained Residents physician’s report. LPA requested for client’s and facility records to be emailed by 4/13/22 by 830a.m.

No deficiencies were cited during this visit

An exit interview was conducted with the Administrator.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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